wavefront therapeutic ablation - 诺贝尔医疗集团∣眼科 .pptVIP

2006年10月28日 中國廈門屈光手術研討會 Early Clinical Outcomes of Epi-LASIK for Myopia in Taiwan Surface Ablation This year( 2006 ) we went B to B Back to Bowman’s Back to Bowman’s There has been a significant movement back to surface ablation. Major recent improvements in surface ablation include gradual blend zones and Mitomycin C for haze. Surface Ablation Concerns for Lamellar Ablation Deeper ablations due to larger ablation zones Increased concern of ectasia Improved visual results? No flap related aberrations Bowman’s membrane a more regular canvas than stroma Surface Ablation Indications Thin corneas Patients predisposed to ocular trauma Detachment surgery Glaucoma Flat corneas Steep corneas Deep-set eyes Surface Ablation Relative to Lamellar ablation No flap related complications No striae Less dry eye No irregular flaps No DLK Surface Ablation In epi-LASIK the epithelial layer is mechanically separated from Bowman’s membrane with the use of a mechanized epikeratome without the use of alcohol. After ablation the epithelial flap complex is positioned on the cornea and a bandage contact lens is placed on the eye. Purpose To evaluate initial clinical outcome with Epi-LASIK for myopia with astigmatism Methods Three months results from a cohort of 56 eyes ( 30 patients ) that had Epi-LASIK procedures with and without Flap Removal as well as PRK were studied .All operations were done with Amadeus 2 ( AMO, Santa Ana ,CA , USA ). Methods For Epi-LASIK,epithelial separation was achieved mechanically without the use of alcohol. The epithelial flap was remained (Option1) or removed (Option 2) and a therapeutic contact lens was applied to the cornea immediately for 3 to 5 days. PRK patients were as usual Postoperative epithelial defect size , symptoms, UCVA, BCVA were evaluated at three months postoperatively. Methods Surgical Parameters Oscillation speed: 11,000 rpm Translation speed: 1.5 mm/sec Suction: 22 mm Hg